I've seen some helpful posts on this site and I hope someone can help me further. I was recently diagnosed with AF but I don't have a fast heart rate. My pulse rarely gets to 59. My doctor has prescribed an anticoagulant (Eliquis) but I'm scared of taking it because of the side effects. I had two bleeding episodes in the past plus I have chronic kidney disease, two conditions mentioned on the Eliquis site that may be contraindicated.
My symptoms are dizziness — walking has become risky — and occasional flutters. I'm fine at home but when I go out I have to hold on to someone. I'm thinking of getting a cane. I'm seeing my doctor in a few days. What should I say to her?
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Calypso76
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AF increases the likelyhood of stroke, which anticoagulants will help reduce. If you are worried then please discuss with your doctor(s). The rate is not relevant to the equation by the way..
You should describe your symptoms which I should think are caused by not enough oxygen being circulated by the slow and irregular heartbeat, also mention your concern about your kidney function, though it is usual to have regular tests of kidney and liver function when on Eliquis. Anticoagulants do not cause bleeding in themselves and presumably your doctor is aware of the cause of the previous events. Anticoagulants can be helpful in that they sometimes flag up issues which might not otherwise be noticed until much worse.
There are 5 anticoagulants available for healthcare professionals to prescribe ... Edoxaban, Dabigatran, Rivaroxaban and Apixaban. Apixaban is also sold under the name Eliquis. These are all fairly new and have only been available for maybe some 8 or 9 years .... whether GP's admit it or not healthcare professionals are still on a learning curve with this stuff. The 5th one is Warfarin ( Coumadin if in USA ) which has been around for some 60 or 70 years but is not so simple to use as it requires levels of testing which don't apply to the others.
Many folk find they cannot handle Warfarin and so these newer drugs are ablessing, however, the reverse also applies now that GP's are pumping the stuff into patients. I would be asking for a major review of medication in view of your medical background. If you have a a Consultant who you see from time to time for your kidney condition I would seek his/her advice on anticoagulation. In my view a GP is just a generalist and they do not have the skill set to prescribe anticoagulants.
Thanks for your response. I think I answered your questions in my reply to someone else. I'm not sure what you mean by "when in AF." Do I have to have a high HR to be in AF? Right now I'm feeling dizzy as I sit typing this and I'm not having any palpitations.
"When in AF" means when you are having an episode of AF, assuming you are not in AF all the time.
No, you don't have to have a high heart to be in AF. For most people, AF is accompanied by a high HR..... However, AF occurs without high HR in some people.
Some people who have AF episodes, do so without feeling symptoms i.e. asymptomatic. For some their episodes are debilitating - and the rest fill the spectrum in between.
I have many questions but others appear to be asking most of them so I will read your responses and see whether any questions remain.
How old are you? What kind of AF do you have -- paroxysmal (sudden and fleeting), persistent (most of the time) or permanent? Has anyone mentioned your CHADS score? This is a standard checklist to determine your risk of stroke, which in turn determines whether you really need to take anticoagulants or can hold off. If your doctor doesn't mention it, ask your CHADS score and what kind of AF you have.
In my case, I developed paroxysmal AF while still in my 40s and have no other health problems, so I had a CHADS score of 1 (solely for being female) and did not need anticoagulants until much later (10 years) -- anticoagulants are recommended for a CHADS score of 2 or higher. Every time I saw a GP in that time, s/he would panic and say 'you need to be on anticoagulants', but every cardiologist I saw in that decade agreed that I did not, yet.
Hi CalypsoI have had AF for several years, 3 ablations and a cardioversion. At the beginning my CHAD Vas score was low so was just on a beta blocker. But as time went on and I had to have an ablation, I was put on Apixiban (Eliquis) because of the risk of bleeds I too was reluctant to take it at first, especially as I have varicose veins and had two bleeds because of this. However there are positives with taking them, the main one is that they will stop a blood clot forming and then travelling to your brain or heart. I was also told by a anti coag pharmacist that if I had a stroke with AF and was not on anticoagulants ithe outcome would be more severe then someone who didn't have AF. The other good news is that there is now an antidote to Apixiban should you have a bleed.
Obviously please discuss everything with your medical specialists. But if you had to have an ablation in the future they wouldn't do it unless you were taking anticoagulants.
Finally, has anyone checked your diziness? Is it heart related or something else? Hopefully a walking stick will help, or you could buy a rollator which gives you greater stability and confidence. I know because I use one. Some health authorities can provide them free of charge so ask your GP if your one does.
Thanks to everyone for your quick and helpful replies. Some of them have provided me with more questions. For instance, what does "when in AF mean?" Does it mean when I feel my heart fluttering or should I have a rapid heart rate? My heart rate has never gone above 59, not even when I'm exercising. As for what type of AF I have? I believe it's paroxysmal - sudden and fleeting. I don't know what a CHAD score is so I don't know what mine is. Oh, I know the answer to one question - I'm 76. I have been fortunate in not being on any long-term meds until now; this is why I dread the idea of having to swallow pills for the rest of my life, but I don't want to have a stroke either. I do see a nephrologist and he has said it's okay to take Eliquis, however, he said I should weigh the pros and cons.
You don't have to have a high heart rate to be in AF. I have permanent AF ad am in Af all the time but my resting heart rate is in the mid 50's but I am always in AF.
Hello again, Have you tried contacting the British Heart foundation? They have trained nurses maning their helpline snd could answer your questions. They also publish a great little booklet called Atrial Fibrillation Your Quick Guide which explains AF really well. The booklet also explains why there is so much concern when someone has A F. Basically because you are 5 times more likely to have a stroke if you don't get treatment. Your beart doesn't always beat very fast with this condition and can also be slower. The common factor is that it doesn't beat in normal rhythm. In addition some people can really feel it and some don't but it is still there. You probably need to wear a holter monitor for 24 hours or more, which will show the type of A F you have. If you are feeling dizzy your Dr should refer you to a cardiologist.
Speaking from personal experience I have been on a beta blocker and blood thinner for many years and so have many others on this chat group please take advice and overcome your fear of pills, if that is what is recommended.
Thanks for taking the time to respond. My cardiologist didn't explain anything about AF to me. He put me on a halter monitor for two weeks (because of my low pulse) and after I turned it in, my primary doctor called me and told me I have AF and need to be on a blood thinner because I could get blood clots or a stroke. I'm leaning toward taking the meds, but I have one question, will they make me feel better overall - less tired, less dizzy? Also, I'm in the US, how do I contact the British Heart Foundation?
HiThe main aim of anticoagulant drugs is to stop you from having blood clots due to your AF. I wouldn't say they serve to make you less tired, but they will give you reassurance that on them you should not worry about having a possible stroke.
I assume that when your medics get the results from the holter monitor, they will decide on drugs or other procedures to to help change your heart rate and rhythm and these may help with some of your symptoms.
The British Heart Foundation website is bhf.org.uk. However, as you live in the US they might not be able to help you, but it's worth a try. You should try and check out if there is a similar heart charity where you are who could help.
My primary doctor sent me to a cardiologist because of my low heart rate. He did an ECG then placed me on a halter monitor then diagnosed me with AF. Thanks for asking.
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